Medical Specialties Commons^™

Vaccine Hesitancy In The United States And Switzerland, Anna E. Lunderberg

Independent Study Project (ISP) Collection

Vaccine hesitancy (VH), or the reluctance or refusal to participate in vaccination programs, is a complex phenomenon with far-reaching impacts on society. VH can impact vaccine uptake and facilitate subsequent outbreaks, as seen with the case of measles. Perceptions of vaccination are similar in the United States and Switzerland, and misinformation in each country contributed to VH through impaired parental risk-benefit analysis; parental analysis and subsequent VH is associated with both anti-vaccination messages gaining prominence and a decrease in the public perception of the health risk from vaccine-preventable diseases (VPDs). There are many proposed strategies for addressing VH on both …

My Body, Their Choice: Childbearing Attitudes And Practices In Jamkhed, Maharashtra, Sienna Sewell

Independent Study Project (ISP) Collection

Understanding the beliefs and practices of women and their families during pregnancy and childbirth is fundamental to the creation of successful public health interventions that target maternal and infant mortality. This study explores the childbearing practices of women in rural Jamkhed, as well as the social and economic factors that influence family planning, reproductive health-seeking, and delivery. Interviews and quantitative surveys were conducted with women in villages that have partnered with the Comprehensive Rural Health Project (CRHP) to examine how and why women access prenatal care during pregnancy. The influence of CRHP’s “Jamkhed Model” on healthcare access is considered in …

Exploring Mobility Help-Seeking Behavior Among People With Physical Disabilities: A Case Study Of Jaipur Foot, Alex Podell

Independent Study Project (ISP) Collection

It is estimated that as many as 90 million people living in India experience some sort of disability (The World Bank, 2007). As India’s population keeps growing and aging, not only will the medical aspects, but also the societal impacts of disability need to be brought to the forefront of discussion, developmental strategy, and policy implementation. This study sought to analyze factors influencing the process of seeking help from formal and informal sources for people with physical disabilities. Data was collected from 10 people with physical disabilities receiving a variety of mobility aids from the NGO, Bhagwan Mahaveer Viklang Sahayata …

Sirva Todos Como Un Hermano: Las Filosofías De Los Médicos Tradicionales Mapuches Hacia Los Pacientes Winka, Andrew Turner

Independent Study Project (ISP) Collection

In recent years, the popularity of traditional Mapuche medicine has increased drastically among non-Mapuche, Winka, Chileans. This increase in the soliciting of services as well as an expansion of intercultural health programming exists within the context of the ongoing Mapuche conflict in which Mapuche activists in the Araucunía region are fighting for the territorial and societal rights of their indigenous communities. To ascertain the effects of Winka medical solicitation on Mapuche medical practioners, semi-structured interviews were utilized. 8 Mapuche medical practioners and associated community members such as intercultural hospital directors and Lonkos were interviewed. Participants were questioned about the personal …

Pasantía En Programa De Integración Escolar (Pie): Apoyando Estudiantes Con Discapacidades En La Escuela Secundaria, Emily Sen

Independent Study Project (ISP) Collection

The intent behind this internship experience was to gain insight into the relationship between an individual’s physical and mental state in the general panorama of one’s health and wellness, specifically among the adolescent population. Throughout this investigation, I actively focused on helping the individuals with whom I was working by cultivating relationships and assisting in therapies. I completed this work in the Student Integration Program (Programa de Integración Escolar), known as PIE, within Liceo A-1 Octavo Palma Pérez, a public high school in Arica, Chile. PIE is a government sponsored program that provides additional resources to students in the public-school …

Pasantía En Red Oss: Más Que Una Clínica, Saad Ehsan

Independent Study Project (ISP) Collection

RED OSS es una organización en Conchalí, Santiago que provee pruebas rápidas de VIH y actualiza otras pruebas para ETS en una manera gratuita desde 1991. Durante mi pasantía, investigué como una organización disminuye las desigualdades de salud. También aprendí sobre el financiamiento de RED OSS, las pruebas rápidas y el nicho de RED OSS en un país con un sistema pública. Utilicé observaciones y entrevistas para estudiar la clínica. Tuve oportunidades para asistir los talleres para prevenir homofobia y ver las consejerías con un voluntario. También actualicé el sitio web para reflejar los servicios que RED OSS ofrece. En …

Is Technology The Key To Prevention Of Falls Among The Elderly In Rapidly Aging Societies? A Case Study Of Kunming, China, Phoebe Kiburi

Independent Study Project (ISP) Collection

As the aging society rapidly becomes more dominant in the world, there is a pressing need for different stakeholders to tend to the needs of the aging sufficiently. This is crucial in ensuring the robustness of the healthcare system as a whole; given that it can only be as strong as its weakest link. This study focuses on one of the areas of need of the ageing society: fall prevention.

Numerous studies have been done on interventions by the government, private entities, elderly people and their caregivers to prevent occurrence and recurrence of falls. However, most of these have been …

A New Paediatric Diabetes Knowledge Test - M-Wikad Development And Factor Analysis., Sarah Tsai, Susana Patton, Stephen Delurgio, David D. Williams, Kavitha Dileepan, Alexander Karmazin, Melinda Storm, Mark A. Clements

Manuscripts, Articles, Book Chapters and Other Papers

Purpose: The purpose of this study was to develop a measure of type 1 diabetes mellitus (T1DM) knowledge that is aimed at youth and is based on contemporary management standards. Methods: An 88-item test was derived from the American Association of Diabetes Educators 7 Self-Care Behaviors. Results: A multidisciplinary team selected the best 49 items which were piloted in a sample of 119 youths (59 males, aged 12-18, having a mean ± standard deviation glycated haemoglobin (A1C) of 9.9%±1.80 (84.7±19.7 mmol/mol). A minimum absolute point-biserial correlation coefficient of 0.250 was used to choose 49 items from the original 88 questions. …

Tamsulosin Use After Shock Wave Lithotripsy: A Systematic Review, Katherine Harte

Senior Honors Projects

Urolithiasis, or the formation of stones in the urinary tract, is a potentially painful process that impacts many people across the world. However, the results of clinical trials disagree on the proper treatment and management of kidney stones. One way to help those who have kidney stones is to perform extracorporeal shock wave lithotripsy (SWL), a medical procedure in which shock waves are directed towards kidney stones to prevent them from migrating and causing pain. Following SWL, patients are sometimes given additional medications, such as alpha blockers (e.g., tamsulosin), to aid in the passage of the stones. However, the benefits …

Abstracts From The 25th Annual Health Care Systems Research Network Conference, April 8–10, 2019, Portland, Oregon

Journal of Patient-Centered Research and Reviews

The Health Care Systems Research Network (HCSRN) is made up of nonprofit health systems with embedded research departments whose scientists are dedicated to public domain research. The network’s annual conference serves as a forum for research teams to disseminate study findings, stimulate new collaborations, and share insights about conducting research in real-world care settings. Abstracts accepted for presentation at HCSRN 2019 are published in this supplement of Journal of Patient-Centered Research and Reviews, the official scientific journal of the conference.

Guidance Of Sentinel Lymph Node Biopsy Decisions In Patients With T1-T2 Melanoma Using Gene Expression Profiling., John T. Vetto, Eddy C. Hsueh, Brian R. Gastman, Larry D. Dillon, Federico A. Monzon, Robert W. Cook, Jennifer Keller, Xin Huang, Andrew Fleming, Preston Hewgley, Pedram Gerami, Sancy Leachman, Jeffrey D. Wayne, Adam C. Berger, Martin D. Fleming

Department of Surgery Faculty Papers

AIM: Can gene expression profiling be used to identify patients with T1-T2 melanoma at low risk for sentinel lymph node (SLN) positivity?

PATIENTS & METHODS: Bioinformatics modeling determined a population in which a 31-gene expression profile test predicted <5% SLN positivity. Multicenter, prospectively-tested (n = 1421) and retrospective (n = 690) cohorts were used for validation and outcomes, respectively.

RESULTS: Patients 55-64 years and ≥65 years with a class 1A (low-risk) profile had SLN positivity rates of 4.9% and 1.6%. Class 2B (high-risk) patients had SLN positivity rates of 30.8% and 11.9%. Melanoma-specific survival was 99.3% for patients ≥55 years with class 1A, T1-T2 tumors and 55.0% for class 2B, SLN-positive, T1-T2 tumors.

CONCLUSION: The 31-gene expression profile test identifies patients …

Rare Variant Of Guillain-Barré Syndrome After Chikungunya Viral Fever, Sajid Hameed, Sara Khan

Section of Neurology

Chikungunya (CHIK) viral fever is a self-limiting illness that presents with severe debilitating arthralgia, myalgia, fever and rash. Neurological complications are rare. We present a case of a 36-year-old woman who presented with acute onset progressive difficulty swallowing and left arm weakness. She was diagnosed with CHIK viral fever 4 weeks prior to admission. After investigations, she was diagnosed with a pharyngeal-cervical-brachial variant of Guillain-Barré syndrome. In hospital, she required ventilator support. Her condition improved after five sessions of intravenous immunoglobulin with almost complete resolution within 6 months of symptom onset. With frequent CHIK outbreaks, the neurological complications are increasingly …

Metastatic Melanoma To The Stomach: A Rare Cause Of Upper Gastrointestinal Bleeding, Ricky Buckshaw Do, Robert V. Decker Md, Shashin Shah Md

Department of Medicine

No abstract provided.

One-Year Results Of The Liberty 360 Study: Evaluation Of Acute And Midterm Clinical Outcomes Of Peripheral Endovascular Device Interventions., Jihad Mustapha, William Gray, Brad J Martinsen, Ryan W Bolduan, George L Adams, Gary Ansel, Michael R Jaff

Heart and Vascular Articles

PURPOSE: To report the 1-year results of a multicenter study of peripheral artery disease (PAD) treatment with a variety of endovascular treatment strategies employed in routine practice.

MATERIALS AND METHODS: The LIBERTY trial ( ClinicalTrials.gov identifier NCT01855412) is a prospective, observational, core laboratory-assessed, multicenter study of endovascular device intervention in 1204 subjects (mean age 69.8±10.7 years; 770 men) stratified by Rutherford category (RC): claudicants (RC2,3; n=501) and critical limb ischemia (CLI) with no/minimal tissue loss (RC4,5; n=603) or significant tissue loss (RC6; n=100). Key outcomes included quality of life (QoL) measures (VascuQol and EuroQol) and freedom from major adverse events …

Usefulness Of An Expanded Health Belief Model With Added Constructs (Self-Efficacy And Ecological System Measures) In Modeling Compliance With Healthy Lifestyle Recommendations In Women With A Recent History Of Gestational Diabetes, Phyllis M. Woodson

Health Services Research Dissertations

Problem Statement: Gestational diabetes (GDM) has been reported to affect as many as 18% of all pregnancies in the U.S. This diagnosis is costly and presents health risks to both baby and mother. The main risk to the mother with a history of GDM is her increased risk for diabetes which has been estimated at 35% to 60% in the following 10 to 20 years; more recent studies report a 7 to 8 times occurrence in the following 3 to 6 years. It is recommended that lifestyle efforts of eating healthfully and exercise can reduce this risk

Methods: Subjects (n=153) …

The Incidence Of Pregnancy Hypertension In India, Pakistan, Mozambique, And Nigeria: A Prospective Population-Level Analysis., Laura A. Magee, Sumedha Sharma, Hannah L. Nathan, Olalekan O. Adetoro, Mrutynjaya B. Bellad, Shivaprasad Goudar, Rahat Qureshi, Andrew H. Shennan, Zulfiqar A. Bhutta, Peter Von Dadelszen

Department of Paediatrics and Child Health

Background:
Most pregnancy hypertension estimates in less-developed countries are from cross-sectional hospital surveys and are considered overestimates. We estimated population-based rates by standardised methods in 27 intervention clusters of the Community-Level Interventions for Pre-eclampsia (CLIP) cluster randomised trials.
Methods and findings:
CLIP-eligible pregnant women identified in their homes or local primary health centres (2013–2017). Included here are women who had delivered by trial end and received a visit from a community health worker trained to provide supplementary hypertension-oriented care, including standardised blood pressure (BP) measurement. Hypertension (BP ≥ 140/90 mm Hg) was defined as chronic (first detected at <20 weeks gestation) or gestational (≥20 weeks); pre-eclampsia was gestational hypertension plus proteinuria or a pre-eclampsia-defining complication. A multi-level regression model compared hypertension rates and types between countries (p < 0.05 …

Comparing The Effects Of Mental Workload Between Visual And Auditory Secondary Tasks During Laparoscopy, James P. Corcoran

Psychology Theses & Dissertations

The purpose of this study was to test Wickens’ Multiple Resource Theory (MRT) by comparing performance and subjective workload on a visual-spatial secondary task with an auditory-spatial analog when paired with visual-spatial laparoscopic primary tasks. Two primary tasks were performed with a laparoscopic box trainer: a high workload task that consisted of transferring rings from one peg to another and a low workload task that consisted of grasping and placing large pencil erasers in a bowl. It was predicted that the visual-spatial secondary task would be more sensitive when paired with the laparoscopic primary task than the auditory analog. Findings …

Contextual Design Choices And Partnerships For Scaling Early Child Development Programmes, Kate M. Milner, Raquel Bernal Salazar, Sunil Bhopal, Alexandra Brentani, Pia Rebello Britto, Tarun Dua, Melissa Gladstone, Esther Goh, Jena Hamadani, Muneera Rasheed

Department of Paediatrics and Child Health

Translating the Nurturing Care Framework and unprecedented global policy support for early child development (ECD) into action requires evidence-informed guidance about how to implement ECD programmes at national and regional scale. We completed a literature review and participatory mixed-method evaluation of projects in Saving Brains®, Grand Challenges Canada® funded ECD portfolio across 23 low- and middle-income countries (LMIC). Using an adapted programme cycle, findings from evaluation related to partnerships and leadership, situational analyses, and design for scaling ECD were considered. 39 projects (5 'Transition to Scale' and 34 'Seed') were evaluated. 63% were delivered through health and 84% focused on …

Large Coronary Arteries Mean No Chance Of A Heart Attack, Right? An Acute Myocardial Infarction In The Setting Of Holding Anticoagulation For A Routine Colonoscopy, Nathan Brewster Do, Jennifer Nesfeder, Ryan Murphy Do, Brian J. Holahan, Syed Rafay Ali Sabzwari

Department of Medicine

Coronary artery ectasia (CAE) is an uncommon pathology, which is sometimes incidentally found on left heart catheterization (LHC). CAE is occasionally treated with systemic anticoagulation to prevent thrombosis or progression of the clot in the coronary arteries. We present a 63-year-old male with known CAE on warfarin who presented to the hospital with myocardial infarction after a routine colonoscopy for which anticoagulation was held. His myocardial infarction was attributed to a likely coronary thromboembolic event. This case highlights the need for consideration of bridging anticoagulation therapy before and after procedures in patients with CAE to prevent adverse coronary events.

The Pharmabiotic For Phenylketonuria: Development Of A Novel Therapeutic, Chloé Elizabeth Lebegue

Senior Theses

Phenylketonuria, now known as phenylalanine hydroxylase (PAH) deficiency, is a genetic disorder of metabolism affecting approximately one in every 15,000 infants born in the United States. Patients have nonfunctional PAH enzyme secondary to one or more genetic mutations. The enzyme deficit results in destructive supraphysiologic blood phenylalanine levels upon consumption of the essential dietary amino acid phenylalanine. Current standards of care mitigate signs and symptoms of the disorder, but do not approach a cure. The methods for creating a prototype pharmabiotic as an innovative treatment strategy for PAH deficiency are described herein.

DNA molecular cloning techniques were utilized to engineer …

Minimally Invasive Endovascular Repair Of Ascending Thoracic Aortic Aneurysm With Use Of Local Anesthesia And Conscious Sedation, Abdelkader Almanfi, Zvonimir Krajcer

The Texas Heart Institute Journal

Ascending thoracic aortic aneurysm (ATAA) is typically treated surgically. No commercially available device has been specifically designed for endovascular ATAA repair, and currently, multiple anatomic and technical challenges affect its feasibility. Previously, such repairs have been performed with the patients under general anesthesia. We describe a novel, minimally invasive approach to endovascular repair of ATAA, involving local anesthesia, conscious sedation, and 24-hour hospitalization. Two consecutive male patients (ages, 79 and 54 yr) who had comorbidities underwent percutaneous transfemoral endovascular ATAA repair with use of commercially available endografts. Patient 1 had a saccular aneurysm, and Patient 2 had a pseudoaneurysm consequent …

Profilaksis Pasca Pajanan Terhadap Hepatitis B, Hepatitisc, Dan Human Immunodeficiency Virus Pada Petugaskesehatan, Alvina Widhani

Jurnal Penyakit Dalam Indonesia

No abstract provided.

Validation Of Ariscat Model Score To Predict Postoperativepulmonary Complications In Tertiary Referral Hospital Inindonesia, Muhammad Alkaff, Ceva Wicaksono Pitoyo, Aldy Heriwardito, Sukamto Koesnoe

Jurnal Penyakit Dalam Indonesia

Introduction. There are several prediction model score instruments that can help to assess pulmonary preoperative evaluation and it is believed that ARISCAT model score is very simple to do and have good performance, but not widely used. This score has not been yet validated in Indonesia. This study aimed to assess the performance of discrimination and calibration of ARISCAT score in predicting postoperative pulmonary complication who underwent surgery in a tertiary referral hospital in Indonesia. Methods. A retrospective cohort study was conducted to assess the external validation of ARISCAT scores in the Indonesian population. This study involved patients underwent surgery …

A Case Series Hemichorea-Hemiballism Syndrome Related Tononketotic Hyperglycemia: A Challenge To Diagnostic Process, Laksmi Sasiarini, Rahmad Budianto, Ricky C. Tarigan

Jurnal Penyakit Dalam Indonesia

Diabetes mellitus is quite familiar to health-care personnel but occasionally presents with unusual manifestations. One of them is hemichorea-hemiballismus syndrome, a spectrum of involuntary, continuous non-patterned movement involving one side of the body which is related to nonketotic hyperglycemia in uncontrolled diabetes. Here we present two cases of nonketotic hyperglycemic diabetic patients who presented with the hemichorea-hemiballismus syndrome. First – a 57 years old woman was presented with involuntary, arrhythmic, and repetitive movement on the right arm and leg, accompanied by twitching on the right face for two weeks. She had an uncontrolled history of diabetes mellitus. The second- a …

Invasive Candidiasis Prevalence Among Patients In Intensivecare Unit, Hasan Sadikin Hospital, Hafizh Ridwan Maulana, Uun Sumardi, Raspati C. Koesoemadinata

Jurnal Penyakit Dalam Indonesia

Introduction. Intensive care unit (ICU) patients have a high risk of invasive candidiasis (IC), which increase mortality and prolong length of stay in hospitals, resulting greater costs. This study aimed to determine the prevalence of IC and associated risk factors in ICU patients. Methods. A cross-sectional study was conducted including medical records of patients treated in ICU Hasan Sadikin Hospital Bandung admitted in June 2016-June 2017 whose blood sample were sent for culture. The prevalence of IC and corresponding 95% confidence interval (95% CI) was determined. A case-control study was done comparing the characteristics of patients with positive culture for …

Profil Of Implementation Of Post Exposure Prophylaxis Of Hepatitis B, Hepatitis C And Human Immunodeficiency Virus To Health Care Worker In Cipto Mangunkusomo Hospital 2014-2016, Dewi Mira Ratih, Evy Yunihastuti, Regina Lestari, Andri Andri Sulaiman, Ikhwan Rinaldi

Jurnal Penyakit Dalam Indonesia

Introduction. Health care workers (HCW) have a high risk of infectious substance exposure. Hepatitis B, hepatitis C, or human immunodeficiency virus (HIV) are some diseases transmitted by body fluid or body tissue. Cipto Mangunkusumo Hospital Jakarta has been implementing post-exposure prophylaxis (PEP)s towards HIV, hepatitis B, and hepatitis C. This study aimed to identify the implementation of post-exposure prophylaxis of HIV, Hepatitis B, and Hepatitis C among HCW in Cipto Mangunkusumo Hospital Jakarta. Methods. A cross-sectional study was conducted to exposed workers in Cipto Mangunkusumo Hospital Jakarta between 2014-2016 who had been recorded by report. Demographic data were collected through …

The Effect Of Green Tea Extract Supplementation On Plasmamalondialdehyde (Mda) In Human With Sub-Maximal Physicalactivity, Double-Blind And Placebo-Controlled Trials, Putu Moda Arsana, Laksmi Sasiarini, Bayu Eka Nugraha

Jurnal Penyakit Dalam Indonesia

Introduction. Green Tea extract has been proven in vitro to have the ability as an antioxidant. Submaximal physical activity causes an increase in free radicals. The increase of MDA can detect the increase of free radicals. This study aimed to determine the effects of green tea extract supplementation against free radicals in submaximal physical activity by measuring plasma MDA. Methods. This double-blind controlled trial study was performed in 20 students of faculty of sports science with submaximal physical activity in the form of 1,500 meters running in 12 minutes using a treadmill. Subjects were divided into two groups: green tea …

Correlation Between The Severity Of Coronary Heart Disease Andqt Dispersion In Patients With Obstructive Sleep Apnea, Rasmijon Rasmijon, Muhammad Yamin, Syahrial M. Hutauruk, Cleopas Martin Rumende

Jurnal Penyakit Dalam Indonesia

Introduction. Coronary heart disease (CHD) and obstructive sleep apnea (OSA) are common and complex clinical problems. Both have a high risk of sudden cardiac death (SCD). QT dispersion (QTd) in electrogram is a measure of heterogeneity of myocardial repolarization that can predict the occurrence of ventricular arrhythmias that cause SCD QTd is a predictor of ventricular arrhythmias and sudden cardiac death. So far, there is no publication about the severity relationship CHD with QTd in OSA patients in Indonesia. Methods. A cross-sectional study was conducted on twenty-nine CHD patients accompanied OSA in 2015 who had undergone coronary angiography and polysomnography …

Clinical Profile Of Cirrhotic Patient With Esophageal Varices Whoundergone Band Ligation In Cipto Mangunkusumo Hospital, Kemal Fariz Kalista, Cosmas Rinaldi Adithya Lesmana, Andri Sanityoso Sulaiman, Rino Alvani Gani, Irsan Hasan

Jurnal Penyakit Dalam Indonesia

Introduction. Liver cirrhosis (LC) is the end stage of chronic liver disease. One of the main complication caused by LC is esophageal varices (EV). Bleeding due to EV rupture is the main cause of mortality in patient with LC. EV band ligation can be used for primary or secondary prophylaxis to prevent bleeding. The purpose of this study was to know the clinical profile of LC patient with EV who underwent band ligation and who not underwent band ligation. Methods. A cross-sectional study was conducted in LC patients who underwent esophagogastroduodenoscopy (EGD) in Procedure Room Division of Hepatobiliary, Departement of …

Using The Qsat To Generate Multi-Source Feedback On An In-Situ Pediatric Simulation Case, Michael C. Nguyen Md, Nicole Elliott Do, Michael R. Jong Md, Msc, Suzanne S. Puentes Bsn, Ccrn, Rn, Diane Begany Md, Matthew D. Cook Do, Louis Morolla Do, Zachary Matuzsan Do, Jennifer E. Macfarlan Mph, Bryan G. Kane Md

Department of Emergency Medicine

No abstract provided.